Objective: Evaluation of neonatal morbidity after maternal central neurotropic drug exposure.
Design/Setting: Retrospective single-center level-III neonatology cohort analysis of neonates after CND from 2018 to 2021. Control group of neonates born to mothers without CND.
Results: Significantly more frequent therapy need of neonates with CND [OR 11 (95% CI: 4.8-25); RR 7 (95% CI: 3.4-14); p<0.01]. Neonates after CND had lower Apgar-scores LM 1 [CND 8.1; CG 8.6; p=0.04]; LM 5 [CND 9; CG 9.7; p<0.01]; LM 10 [CND 9.6; CG 9.9: p=0.01]). The first symptom occurred in 95.35% within 24 h (mean: 3.3 h). CND group showed significantly more often preterm delivery [OR 3.5; RR 3.2; p<0.05], and especially cumulative multiple symptoms [OR 9.4; RR 6.6; p<0.01] but no correlation to multiple maternal medication use (p=0.3).
Conclusion: Neonates exposed to CND are at increased risk for postnatal therapy, often due to multiple symptoms. Neonates should be monitored for 24h.
Objectives
Establishing immediate intravenous access to a newborn is challenging even for trained neonatologists in an emergency situation. Correct placement of umbilical catheter or an intraosseous needle needs consistent training. We evaluated the time required to correctly place an emergency umbilical button cannula (EUC) or an umbilical catheter (UC) using the standard intersection (S-EUC or S-UC, respectively) or lateral umbilical cord incision (L-EUC) by untrained medical personnel.
Methods
Single-center cross-over pilot-study using a model with fresh umbilical cords. Video-based teaching of medical students before probands performed all three techniques after assignment to one of three cycles with different sequence, using a single umbilical cord divided in three pieces for each proband.
Results
Mean time required to establish L-EUC was 89.3 s, for S-EUC 82.2 s and for S-UC 115.1 s. Both application routes using the EUC were significantly faster than the UC technique. There was no significant difference between both application routes using EUC (p=0.54).
Conclusions
Using an umbilical cannula is faster than an umbilical catheter, using a lateral incision of the umbilical vein is an appropriate alternative.
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